Theses and Dissertations
Advisor
Nukpezah, Julius A.
Committee Member
French, P. Edward
Committee Member
Potter, Michael R.
Committee Member
Abutabenjeh, Sawsan
Date of Degree
5-16-2025
Original embargo terms
Embargo 2 years
Document Type
Dissertation - Open Access
Major
Public Policy and Administration
Degree Name
Doctor of Philosophy (Ph.D.)
College
College of Arts and Sciences
Department
Department of Political Science and Public Administration
Abstract
The persistent disparities in Black maternal health outcomes, despite Medicaid expansion under the Affordable Care Act (ACA), identifies a complex public health crisis with widespread consequences. This dissertation examines the failure of Medicaid expansion to significantly improve Black maternal health, focusing on the Mississippi Delta; a region plagued by systemic health inequities. While studies indicate that Medicaid expansion correlates with a decline in maternal mortality rates among Black women, they continue to face disproportionately high rates of pregnancy-related complications and deaths compared to their White counterparts. Using Critical Black Feminism as a theoretical and methodological framework, this research integrates historical context, tracing Black maternal health from the era of slavery to the present. It highlights the multifaceted root causes of health disparities, including systemic racism, limited access to quality healthcare, and social determinants such as poverty, housing insecurity, transportation and food instability. Firsthand accounts from Black women in the Mississippi Delta illustrate the barriers they face in accessing maternal healthcare, while interviews with medical providers reveal the systemic challenges that hinder the delivery of equitable care. Insights from Mississippi legislators shed light on the political and structural obstacles that continuously reject Medicaid expansion and its effectiveness in addressing maternal health disparities. A comprehensive analysis of legislative efforts to expand Medicaid in Mississippi from 2014 to 2024 reveals key factors stalling progress. Findings indicate that while Medicaid expansion is a critical social determinant of health, it is insufficient on its own to address the structural and systemic issues that contribute to poor maternal health outcomes among Black women. A holistic approach is necessary; one that not only expands Medicaid but also tackles the broader social determinants of health, such as poverty, transportation, childcare, and housing insecurity, while confronting systemic racism within healthcare and legislative systems. The study concludes that Medicaid expansion efforts have a higher likelihood of success when led by White conservative Republicans with Black co-sponsors, reflecting the racial dynamics influencing policy advocacy in Mississippi. Although significant challenges remain, the findings suggest a path forward through comprehensive policy reform, community engagement, and targeted interventions to improve Black maternal health outcomes in the Mississippi Delta and beyond.
Recommended Citation
Gray, Brittany L., "Toward social equity in Black maternal health in Mississippi" (2025). Theses and Dissertations. 6493.
https://scholarsjunction.msstate.edu/td/6493
